Should Partners Be Given STD Prescriptions, Too?

Prescribing drugs to treat sexually transmitted diseases (STDs) to both sexual partners when only one seeks such treatment during a doctor’s visit may reduce the incidence of STDs, according to a recent study published in the journal Sexually Transmitted Infections.

But while this may seem like a fairly straightforward way to reduce STD rates, not every state legally allows it. Thirty-eight states currently allow expedited partner therapy (EPT), in which doctors and other medical professionals can prescribe treatment to both partners. Several major health organizations, including the Centers for Disease Control & Prevention (CDC), also support EPT.

To find the connection between the legal status of EPT in states and STD rates, the study’s researchers reviewed reported chlamydia cases over a three-year period in states that don’t allow EPT and states that do allow it.

They found states that prohibited therapy for both partners had higher rates of chlamydia — 17.5 cases for every 100,000 people compared to about 14 cases for every 100,000 people in states where the practice was legal.

The study’s findings make it clear that there’s a link between allowing EPT and the prevalence of STDs in the community. However, it’s understandable why some states legally prohibit. As  doctors, we’d never prescribe a drug to a patient without a thorough assessment. At the same time, the public health consequences of STDs — and the very real risk of spreading infection — may be reason enough for many states to at least consider EPT. In most states where EPT is legal, the law also protects against liability for doctors, thereby reducing their risk of prescribing to someone’s partner. There are also several ways doctors can learn about a partner’s allergies before prescribing the medication, which also increases safety.

According to the most recently available federal data, there were 1.4 million chlamydia cases in 2015, a 2.8 percent increase compared to 2013. Syphilis and gonorrhea rates also have risen in recent years, leading the CDC to say “America’s worsening STD epidemic is a clear call for better diagnosis, treatment, and prevention.” 

The agency currently advocates for EPT because it says the practice reduces rates of reinfection, protects both partners and reduces damage to a woman’s reproductive system. The CDC also says studies have shown partners who receive EPT were 29 percent less likely to be infected with an STD compared to those who were just told by their partners to seek treatment.

Prescribing STD medications to both partners eliminates a step that can be a barrier to treatment. In states that have implemented EPT, such as Michigan and Illinois, the practice has increased access to treatment and has led to more awareness, education and prevention. 

The study’s researchers say EPT should be part of a “multipronged strategy” to prevent and treat chlamydia and other STDs and that states that don’t yet allow this practice should reconsider changing their laws so doctors can prescribe these medications to both partners. As the data shows, STD rates continue to climb. If EPT can help reverse this trend, it is worth serious consideration to help us combat this public health challenge.